Time Saving Tips

1. Be Prepared

¨ Preview patient charts before you come to clinic or at the beginning of the session.

¨ Identify any information you will need for the visit and gather it beforehand (eg. test results).

¨ Discuss patient management questions with the attending before going into the exam room.

¨ Touch base with the MA or RN assigned to you. If you know that a patient will need a special set-up or intervention, let them know so that they can have the patient/equipment ready for you.

¨ Complete any paperwork ahead of time that you know will be needed during the course of the afternoon.

2. Set the Agenda

¨ Decide what you want to cover during the visit.

¨ Elicit the patient’s agenda for the visit – what do they want to accomplish?

¨ Prioritize agenda items.

¨ Assess how many items can be covered during the time available for the visit and negotiate the final agenda for the visit.

¨ At the end of the visit, set a preliminary agenda for the next visit.

3. Presenting to the Attending

¨ Be overt! Let the attending know if you are under time pressure.

¨ Decide what you want to get from the attending and let the attending know your needs.

¨ Have a specific question.

4. Charting

¨ Document immediately after seeing the patient. You can always edit the note later if you make significant changes after reviewing the patient with the attending.

¨ Use a format that allows you to easily access information.

¨ Include the preliminary agenda for the next visit in the note.

5. Schedule Follow-up

¨ Scheduling patients at intervals that are either too short or too long will decrease your efficiency.

¨ 1 year follow-up: for healthy patients whose main need is preventive care.

¨ 6 month follow-up: for stable patients with one or two chronic conditions in good control on a limited number of medications.

¨ 3-4 month follow-up: for stable patients with two or more chronic conditions in good control on multiple medications.

¨ 1 month-follow-up: for patients with poorly controlled medical conditions, changing therapeutic regimens, significant psychosocial needs, chronic narcotic therapy.

¨ < 1 month follow-up: for patients with acute conditions.

6. Delegate

¨ Identify others who can help you care for your patient. Nurses, pharmacists, diabetes educators, social workers and chemical dependency counselors can all participate in the care of your patients.

¨ Attending physicians and nurse practitioners can see your patients for one time visits to follow-up on specific issues when your schedule does not allow you to see the patient yourself.

7. Use the Phone (and email)

• When possible follow-up with patients by phone.